Evidence map›Paper›PMID 33338645›Full record

ArticleAnnals of epidemiology2021

Urinary albumin-to-creatinine ratio within normal range and all-cause or cardiovascular mortality among U.S. adults enrolled in the NHANES during 1999-2015.

Kosuke Inoue, Elani Streja, Tetsuro Tsujimoto, Hiroki Kobayashi

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kosuke InoueDepartment of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles. Electronic address: koinoue@ucla.edu.
Elani StrejaHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology & Hypertension, University of California Irvine School of Medicine, Orange.
Tetsuro TsujimotoDepartment of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan; Department of Diabetes and Metabolism, Toranomon Hospital, Kawasaki, Japan.
Hiroki KobayashiSection on Genetics and Epidemiology, Research Division, Joslin Diabetes Center, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA. Electronic address: Hiroki.Kobayashi@joslin.harvard.edu.

Funding

Effects of Chronic Kidney Disease on Cardiovascular Disease and Dementia Among People with Diabetes: Causal Modeling with Machine Learning ApproachF99DK126119 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI INOUE, KOSUKE · 2020 to 2020
$34k
NIDDK NIH HHS F99 DK126119
6 · The paper itself

Abstract

purposeUrinary albumin-to-creatinine ratio (UACR) is one of the important diagnostic markers of chronic kidney disease. We aimed to investigate the association between UACR within normal range and cardiovascular or all-cause mortality.

methodsThis study included a nationally representative sample of 31,413 U.S. adults aged greater than or equal to 20 years enrolled in the National Health and Nutrition Examination Survey 1999-2014. Mortality was ascertained through 2015. We used multivariable Cox proportional models to investigate the association of UACR with all-cause and cardiovascular mortality. Stratum-specific analyses were conducted by age, sex, race, education status, and comorbidities (e.g., hypertension, diabetes, cardiovascular disease, and chronic kidney disease).

resultsOver a median follow-up of 7.6 years, 2854 all-cause deaths and 454 cardiovascular deaths were identified. Higher UACR (per 10 mg/g) was associated with increased risk of all-cause mortality (adjusted hazard ratio = 1.29, 95% confidence interval = 1.22-1.37) and cardiovascular mortality (adjusted hazard ratio = 1.34, 95% confidence interval = 1.17-1.55). The association was larger among women for both all-cause and cardiovascular mortality, and among younger and highly educated participants only for all-cause mortality. The association did not differ by the presence of comorbidities.

conclusionsElevated UACR within normal range was associated with higher all-cause and cardiovascular mortality risk across almost all subgroups including participants without comorbidities. Our findings suggest the importance of the early detection of albuminuria and careful evaluation of UACR even within normal range to reduce mortality risk.

Indexed as

AlbuminuriaCardiovascular DiseasesCause of DeathCreatinineAdultFemaleHumansMaleNutrition SurveysReference ValuesRisk AssessmentUnited StatesCreatinineMortalityNHANESNormal rangeStratificationUrinary albumin-creatinine ratio

Identifiers

PMID33338645
PMCPMC8202057

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.